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The history of public health is dynamic and being generated on a constant basis. Diseases have provided the stimulus for much of the activity in public health. In a handful of instances, overcoming a disease has removed a barrier to commerce or another desired goal. For example, overcoming yellow fever facilitated construction of the Panama Canal in the early 1900s, and finding a cure for scurvy allowed mariners to make longer voyages of exploration. It is important to note that advances in public health usually have impacts on people throughout the world and that public health is an...

The history of public health is dynamic and being generated on a constant basis. Diseases have provided the stimulus for much of the activity in public health. In a handful of instances, overcoming a disease has removed a barrier to commerce or another desired goal. For example, overcoming yellow fever facilitated construction of the Panama Canal in the early 1900s, and finding a cure for scurvy allowed mariners to make longer voyages of exploration. It is important to note that advances in public health usually have impacts on people throughout the world and that public health is an international effort. Public health researchers are focusing on heart disease and type 2 diabetes in response to contemporary epidemics. Efforts to understand and cure diseases have had the unintended consequences of developing tools. The science of epidemiology emerged from efforts to stop cholera in England. In addition, forces other than disease have affected public health. Examples include the sanitary movement that began in England and was quickly duplicated in a new England (mid-1800s), social concerns that reformers used to promote mandatory schooling for children as a way to stop child labor in factories (mid-1800s), and concern for wholesome food (late 1800s). A small number of diseases have had a disproportionate impact on the history of public health throughout the world. These include smallpox, influenza, tuberculosis (TB), and HIV/AIDS. The first three diseases have been known since antiquity; HIV/AIDS is a more recent problem. Smallpox is noteworthy for its mortality rate and because it is the only disease that has been eradicated. Influenza became a human disease after individuals domesticated pigs. Because influenza mutates so readily, it continues to challenge public health planners. In periodic pandemics, influenza kills many people. Tuberculosis, like influenza, migrated to humans after cattle were domesticated. TB is a concern for public health for at least two reasons. Experts estimate that one person in three carries the TB pathogen. Because the length of time required to treat TB is long (months), most strains of TB have developed drug resistance. Finally, as of 2010, HIV/AIDS has caused more than 40 million deaths. With the exception of HIV/AIDS, vaccines have been developed for these diseases. The smallpox vaccine provided the means for eradication, whereas influenza mutates so readily that the vaccine must be frequently revised. A vaccine for TB is also available, because it is not effective in all recipients, it is not used in the United States as a matter of public health policy.